Now that the long and often angry debate over health care reform has produced a new law, its merits and flaws will finally get to be tested in reality rather than in the speculation and conjecture that have shaped its reputation to this point.
This problem is not unfounded. After President Franklin Roosevelt announced his plan for a social security program to protect the jobless, the elderly, and widows against what he later characterized as the “hazards and vicissitudes of life,” the New York Times published the entirety of the proposed bill on Jan. 18, 1935, over three pages.
Nearly 75 years later, the fact that the highly complex health care reform package came in a 1,990 page document fueled the uncertainty and distrust that was expressed at town hall meetings and in rallies all across the nation. Even after its passage, the task of figuring out just what is in it remains challenging.
Like Social Security, health care reform is expected to extend insurance coverage to 30 million Americans who would not otherwise be covered. Reformers have correctly trumpeted this fact as a major accomplishment that ought not to be considered lightly. Those that plan to campaign for repeal will face troubling questions about how to otherwise indemnify people who will be covered once the law goes into effect.
It is, however, equally difficult to miss that the law’s financial implications are tenuous at best over the long run. On this account, the derisive comparisons between the reform opponents of 1935 and 2010 lose some of their spite.
The passage of time hasn’t been kind to 1936’s Republican Presidential candidate Alf Landon, who campaigned on the repeal of the Social Security Act. In a speech entitled “I Will Not Promise the Moon,” Mr. Landon noted this about the government’s proclivity to spend rather than save: “There is every probability that the cash they pay in will be used for current deficits and new extravagances.” Though the turning pages of history haven’t improved his popularity, they have proved him correct.
And perhaps so to shall it be with health care reform. The Congressional Budget Office estimates, which have been trumpeted by the President and other reformers, assert that the changes will reduce the federal deficit over the next two decades. Hopefully, these projections turn out to be more accurate than those used in the past. In 1965 at the inception of Medicare, it was estimated that the program’s 1990 cost would be $12 billion. It actually cost $107 billion.
Skeptics may not be popular, but their concerns are well justified.
This muddled picture of costs and benefits makes it difficult to find sensibility amid the reforms. The moral certitude that comes from extending coverage to millions of Americans is tempered by the moral bankruptcy of ignoring the financial pitfalls for the entire nation. If history serves as a guide then both sides will be able to find validation for their views.
Heath W. Fahle is a policy analyst and consultant based in Manchester. His background in political campaigns includes work for former U.S. Rep. Rob Simmons and the Connecticut Republican Party. He is also the principal of Revolutionary Strategies LLC, a Web site design and consulting firm. Learn more at www.heathwfahle.com.